Job Title: Remote Nationwide Supervisor of Quality Assurance Operations - HEDIS

Join Optum, a global organization dedicated to delivering care and leveraging technology to improve the lives of millions. As a Supervisor of Quality Assurance Operations, you will play a vital role in enhancing health outcomes by connecting people with the care, resources, and benefits they need to thrive. Our culture is built on inclusion, talent, comprehensive benefits, and career development opportunities, allowing you to make a meaningful impact on the communities we serve while advancing health optimization on a global scale.

In this role, you will lead a team of LPNs in year-round HEDIS medical record collection and provider outreach, serving as a subject matter expert and providing guidance on system, outreach, and technical specifications. Through quality reviews, call monitoring, and reporting, you will ensure data submitted to health plans meets HEDIS/STAR technical specifications, providing actionable feedback to promote staff success. You will also assist the Director of Quality Operations in communicating prioritization, strategy, and best practices.

This remote position offers flexibility and the opportunity to work from anywhere within the U.S. Your primary responsibilities will include:

• Serving as a subject matter expert to clinical staff
• Coordinating daily business activities and performing quality assurance on data mining and provider outreach
• Navigating multiple documentation systems and obtaining medical record sections supportive of HEDIS/Star measures
• Reviewing scanned records and data entry into supplemental data applications
• Maintaining education and knowledge base of HEDIS/STAR standards and guidelines
• Pulling and reviewing quality and productivity reporting
• Conducting training on HEDIS/STAR measures, data collection software, and strategies
• Assisting with team coordination of system changes and upgrades
• Participating in debrief activities and process improvement exercises

To succeed in this role, you will need:

• Active and unrestricted licensure as a Registered Nurse (RN) in the state(s) of practice
• 3+ years of HEDIS experience
• 2+ years of call center experience
• 2+ years of experience as a team leader or SME
• Excellent training and presentation skills with solid communication capabilities
• Proven experience using Microsoft Office applications, including databases and Excel spreadsheets
• Access to high-speed internet

Preferred qualifications include a Bachelor's Degree, Certified Professional Coder, and supervisory or management experience. You will be rewarded and recognized for your performance in an environment that challenges you and provides clear direction for success. The salary range for this role is $71,600 to $140,600 annually, with comprehensive benefits, incentive and recognition programs, and equity stock purchase and 401k contribution.

At UnitedHealth Group, we are committed to helping people live healthier lives and making the health system work better for everyone. We believe in mitigating our impact on the environment and enabling equitable care that addresses health disparities and improves health outcomes. Join us to start Caring. Connecting. Growing together.

UnitedHealth Group is an Equal Employment Opportunity employer and a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Apply Now

Apply Now

Apply Now

Apply Now